I have never seen any published data on tip migration, probably
because it is so hard to actually document. The tip may be up in the
IJ in the morning but within a short period it has spontaneously
repositioned itself to the original location. Years ago there was an
article in an early NAVAN journal about this problem. I have never
seen any that migrated to the contralateral subclavian. Would those in
the mid or upper SVC be due to catheter dislodgement rather than
spontaneous migration due to intrathoracic pressure changes? Can you
eliminate those by a catheter stabilization device and education about
dressing change procedures? I would not like to use a tip that is
located above the mid-SVC. Lynn
At 10:32 AM -0600 3/29/06, Margy Galloway wrote:
Colleagues,
Our PICC team has been discussing (frequently) the issue of malpositioned catheter tips that
occur when we place PICCs (not after completion). With a 7 member team we all have opinions about
what is considered usable such as "only" lower 1/3 SVC, "only" ACJ, mid SVC, upper SVC, or junction
of brachiocephalic/SVC. I would like to know what your thoughts are regarding the use of malpositioned
tips. How often do you think this happens in your practice? How often do you feel (in your practice) tips travel to the IJ,
the contralateral side, the azyogus, or even into the R atrium causing you to reposition or replace the PICC?
Thanks for your input with our questions. We have looked at the Navigator and am not interested in using this
device at this time but would like to compare our practice with others.
Margy Galloway, RN
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
